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Pitching Your Business to the Media Reg. Form- March 8, 2017 INC
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Pitching Your Business to the Media Reg. Form- March 8, 2017 INC
First Name:
*
Last Name:
*
Company:
*
Street Address:
*
City:
*
State/Province:
*
Email:
*
Phone:
*
Industry:
*
--None--
Accommodation and Food Services
Adm.&Spprt & WasteMgmt & RemediationSvcs
Agriculture, Forestry, Fishing & Hunting
Arts, Entertainment, & Recreation
Banking
Biotechnology
Chemicals
Communications
Construction
Consulting
E-commerce
Educational Services
Electronics
Energy
Engineering
Environmental
Fashion
Finance and Insurance
Government
Health & Beauty
Healthcare Care and Social Assistance
Hospitality
Information
Insurance
Machinery
Management of Companies and Enterprises
Manufacturing
Media
Mining
Not For Profit
Other
Other Svcs (except Public Adm)
Prof., Scientific, and Tech Svcs
Public Administration
Real Estate Rental and Leasing
Recreation
Retail Trade
Services
Shipping
Telecommunications
Transportation and Warehousing
Utilities
Wholesale Trade
Business Sector::
*
Business Services
Financial Services
Health & Beauty
Information/Publishing
Manufacturing/Industrial
Other
Retail
Technology
Website:
*
Business Start Date:
*
Business Plan:--None--YesNo:
*
--None--
Yes
No
Marketing Plan:--None--YesNo:
*
--None--
Yes
No
Gross Revenue for Prior Full Year:
*
Projected revenue for this year?:
*
What's your biggest challenge?:
*
Birthdate:
*
Ethnicity::
*
--None--
American Indian/Alaskan Native
Asian
Black/African American
Hispanic/Latino
White/Caucasian (non-hispanic)
Native Hawaiian/Pacific Islander
Other
Gross household income::
*
--None--
Less than $10.000.00
$10,000.00 to 14,999.00
$15,000.00 - $24,999.00
$25,000.00 - $49,000.00
$50,000.00- $99,000.00
$100,000.00 -$149,000.00
$150,000.00 - $199,000.00
What organization referred you to this workshop?:
*
*
These fields are required.
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